zahra sadat madani

Osteoporosis and periodontitis are two diseases associated with bone loss and are common among postmenopausal women. There are many contradictory results on the effect of osteoporosis on periodontal tissue. This study aimed to determine the association between osteoporosis and periodontal status in postmenopausal women.

This cross-sectional study was part of the second phase of the Amir kola Health and Aging Project (AHAP), in which 210 postmenopausal women were randomly divided into three groups (n=70 per group); normal bone density group,  osteopenic group, and osteoporotic group. Periodontal status was measured using Periodontal Disease Index (PDI), Plaque Index (PI), and Simplified Oral Hygiene Index (OHI-S). Bone mineral density (BMD) was measured by Dual-energy X-ray absorptiometry (DEXA). Data were analyzed in SPSS V17 applying ANOVA, Kruskal-Wallis, and Pearson correlation coefficient.

The average age of the participants was 65.24±4.36 years. There were no statistically significant differences between the mean OHI (2.26±1.40), PDI (2.76±1.42), and PI (1.23±0.87) in the osteoporotic group, and the mean OHI (2.01±1.62), PDI (2.56±1.61), and PI (1.35±0.91) in the osteopenia group, and mean OHI (1.73±1.37), PDI (2.47±1.43), and PI (1.23±0.87) in the normal group (P>0.05). The OHI, PDI, and PI had a slight but insignificant negative correlation with BMD.

According to this study, there is no link between osteoporosis and periodontal status in postmenopausal women.

Considering that nutrition plays a prominent role in the health of the elderly, oral health and the associated quality of life are very important for a healthy diet. The aim of this study was to investigate the association between the frequency of fruit and vegetable consumption and oral health-related quality of life (OHRQoL) among the elderly in Amirkola.

 This study was part of the second phase of the Amirkola elderly cohort study conducted on 750 older people who underwent a special oral and dental examination in 2016-2020 using the Oral Health Questionnaire. The frequency of fruit and vegetable consumption was assessed with the  Semi-Quantitative Food Frequency  Questionnaire (SQFFQ), OHRQoL was assessed with the  General Oral Health Assessment Index (GOHAI), and information on age, sex, history of systemic diseases, and the number of teeth was extracted from the full data set completed by specialists for each patient. Data were analyzed with SPSS 20 using the chi-square statistical test, ANOVA, and Pearson correlation coefficient. A value of p<0.05 was considered significant.

 Non-smokers and people with a higher level of education had a better OHRQoL (P=0.022 and P=0.036, respectively). There was no significant relationship between the frequency of fruit and vegetable consumption and OHRQoL, but a significant relationship was found between the frequency of fresh herb consumption and OHRQoL (p=0.005). In men, there was a significant relationship between the number of teeth and frequency of vegetable consumption as well as between OHRQoL and frequency of fresh herb consumption in men (P=0.048, r=0.096).In women, a significant relationship was observed between the frequency of total vegetable consumption and OHRQoL (p=0.021, r=0.129).

According to the results of the present study, it was found that the amount of fruit and vegetable consumption has no effect on improving the OHRQoL among the elderly of Amirkola city.

Pulp stones are calcified masses in the pulp chamber or root canals. Cone-beam computed tomography (CBCT) can identify crown and root anatomy and also detect calcifications which may help to achieve a better diagnosis. The goal of this study was to determine the frequency of pulp stones in CBCT images.

In this cross-sectional study, 500 CBCT images in Babol, north of Iran were included. Pulp stones were detected by NNT viewer software in axial, coronal and sagittal dimensions by the presence of a round or oval appearance of a single dense mass in the pulp cavity or root canals. Parameters such as age, sex, type of tooth and jaw and side involved, condition of the tooth (healthy, decayed/repaired), and location of pulp stone (crown and cervical, middle, apical one third of the root) were identified and recorded in a checklist. Data were analyzed by SPSS V22 applying Independent Samples T-test and Chi-square test.

The mean age of participants was 38.80±14.35 years. Pulp stones were reported in 71 individuals (14.2%) and 119 teeth (0.93%). The frequency of pulp stones was significantly higher in women, maxilla, molars, healthy teeth, and crown pulp (P< 0.05). The frequency of pulp stones was not significantly different between the left and right sides (P= 0.343). Findings showed no significant difference in mean age between people with and without pulp stones (P= 0.334).

In this study, the prevalence of pulp stone was low and they were more common in women, maxillary, molars, healthy teeth, and crown pulp.

Hypertension is one of the most common chronic diseases in the world. The prevalence of hypertension in the elderly is increasing. Patients with high blood pressure have to take medication throughout their lives. In this study, the relationship between antihypertensive drugs and oral health-related quality of life in the elderly was evaluated.

This modified cross-sectional study, which is the part of the second phase of the Amirkola Health and Ageing Project (AHAP), was performed on 900 elderly people. Participants included 300 people with hypertension under medical treatment, 300 people with hypertension without medication and 300 people with normal blood pressure. All patients’ blood pressure was recorded, and the standard xerostomia questionnaire and GOHAI questionnaire (Geriatric Oral Health Assessment Index) was completed for all participants. Then, the obtained data were analyzed by SPSS 17, whereby student’s t-test, ANOVA and chi square, Pearson correlation coefficient and logistic regression model were used. A p<0.05 was considered statistically significant.

The mean GOHAI score in the three studied groups: hypertensive under medication treatment, hypertensive without medication treatment and normal blood pressure (51.1±7.4, 51.7±7.3, 51.1±7.5, respectively) did not differ significantly (P=0.533).The frequency of xerostomia was significantly different in the three groups (P=0.008). Among the antihypertensive drugs, the highest rate of xerostomia was due to the use of calcium channel blockers (31.1%) and diuretics (26.8%).

In our study, although antihypertensive medications were associated with xerostomia, they did not decrease the oral health-related quality of life.

Type 2 diabetes mellitus (T2DM) is the most common form of diabetes, and a metabolic disorder affecting patientschr('39') general health in various ways. The present study aimed to evaluate the oral health-related quality of life (OHRQoL) among older adults of Amirkola, Northern Iran.

A case-control study was conducted with a sample of 500 elderly people (250 with T2DM and 250 healthy controls) who answered geriatric oral health assessment index (GOHAI) questionnaire and a questionnaire evaluating xerostomia. Then, all participants underwent clinical dental examinations. The obtained data were then analyzed by t-test, chi-square test, and Pearsonchr('39')s correlation coefficient, and p < 0.05 was considered significant.

The prevalence of xerostomia was not statistically significant between the T2DM patients and control groups (p < 0.079). Greater number of patients suffering T2DM reported xerostomia according to the records; however, the correlation between this disorder and periodontal disease index (PDI), Plaque index (PI), oral health index-simplified (OHI-S), and geriatric oral health assessment index (GOHAI) in the subjects of the two study groups was not significant (p < 0.0001).

In the present study, there was no significant relationship between GOHAI and periodontal indices, demonstrating no difference in the OHRQoL of elderly patients with T2DM and older healthy adults.

The aim of this study was to investigate the accuracy of Cone-beam computed tomography(CBCT) in detecting the horizontal root fractures (HRFs) in teeth with and without gutta-percha.

This in vitro study was performed on 100 mandibular and maxillary single-rooted teeth. In 55 samples, the canals were prepared. Then, the horizontal fracture was induced randomly in 56 (29 with gutta-percha, 27 without gutta-percha) samples. The samples were mounted on a wax rim, and the CBCT scan was provided. The scans were examined by two endodontists twice with two-week interval. Data were analyzed using IBM SPSS 20.0 software (IBM Corp., Armonk, IL, USA). Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio (LR +, LR -) with 95% confidence interval were calculated.

The sensitivity and specificity were 72% and 100% for the group with gutta-percha as well as 89% and 100% for the group without gutta-percha, respectively. The coefficient of agreement for each observer within two observations was 0.940±0.034 and 0.960±0.028 (P<0.001). The inter observer agreement was 0.092±0.039 (P<0.001).

The CBCT scans have high accuracy in diagnosis of horizontal root fracture and gutta-percha although they reduce the diagnostic accuracy with no significant effect.

Calcium silicate cements in treatments such as revascularization and apexogenesis are adjacent to blood and pulp tissues. This study evaluated tooth discoloration after treatment with mineral trioxide aggregate (MTA), calcium‑enriched mixture (CEM) cement, and Biodentine® in the presence and absence of blood using spectrophotometric analysis.

In this experimental study, A total of 68 extracted permanent anterior teeth were prepared and randomly divided into two groups as follows: the sponge embedded in access cavities was saturated with fresh blood or normal saline using insulin syringe, and then each group was subdivided into the following three cement subgroups: MTA‑Angelus®, CEM cement, and Biodentine; these materials with a thickness of 3 mm were placed in the access cavity on the sponge. In the control group, the sponges were saturated in saline and blood in the absence of cements. Discoloration rate was measured by spectrophotometer within the following four intervals: after preparing the cavity and 1 day, 1 month, and 6 months after material placement. ANOVA and Tukey’s test were used to assess the effect of blood and materials and time on discoloration. (P < 0.05).

In general, discoloration rate is significantly higher in blood group than saline group (P < 0.05) and an increase in ∆ E is observed over time for the materials in all groups. In this study, discoloration rate in the presence and absence of blood in Biodentine group was lower, and this difference was statistically significant compared to that of MTA group (P < 0.05) but not significant compared to that of the CEM group.

This study indicated that Biodentine induces the lowest tooth discoloration in the presence and absence of blood, and its discoloration rate is significantly lower than that of MTA. Therefore, it can be suggested that Biodentine can be used more confidently for endodontic treatments with coronal blood contamination such as regeneration and cervical perforation repair in esthetic zone of teeth.

The purpose of this study was to compare the high resolution cone-beam computed tomography (CBCT) and standard mode CBCT diagnostic accuracy in internal root resorption with different sites and sizes. Methods and Materials: Eighty single rooted human teeth with visible pulps in periapical radiography were split mesiodistally along the coronal plane. Internal resorption like lesions were created in three areas (cervical, middle and apical) in labial wall of the canals in different diameters. High resolution CBCT (CBCT-H) and standard mode CBCT (CBCT-C) were taken from each tooth. Two observers examined the high resolution CBCT and standard mode CBCT to evaluate the presence of resorption cavities. The data were statistically analyzed and degree of agreement was calculated using Cohen’s kappa (k) values. Data were analyzed by SPSS 20 software and sensitivity, specificity and positive and negative predictive value for both methods were calculated. Data were analyzed using the Mac-Nemar and chi-square tests. The positive predictive value and negative predictive value in CBCT-H was higher than that of CBCT-C, all of which indicates that the CBCT-H diagnostic test is more sensitive and more accurate than CBCT-C. Kappa statistics showed that there is a strong and complete agreement between the CBCT high resolution and reality (kappa: 0.72) and in the Standard CBCT method, a moderate agreement has been obtained with reality (Kappa: 0.45). According to our in vitro study CBCT high resolution has a higher diagnostic accuracy than conventional CBCT.

One of the main reasons for extraction of endodontically treated teeth is vertical root fracture (VRF). Some factors such as root canal treatment are involved in vertical root fracture because of their potential to weaken the tooth structure. Therefore, this study aimed to investigate the effect of combining different obturation materials and rotary systems on the fracture resistance of treated teeth.
Eighty extracted maxillary central incisors were selected. The coronal portions of all teeth wereremoved at the cemento-enamel junction leaving the root segment of nearly 13 mm length. Roots were randomly divided into2 groups according to the system used in root canal preparations, Group I: ProTaper, Group II: Wave 1. Each main group was further subdivided into 2 equal subgroups according to the obturation system being used, Subgroup A: ProTaper, AH26 obturator, Subgroup B: ProTaper, Bioceramic, Subgroup C: Wave 1, AH26 obturator and Subgroup D: Wave 1, Bioceramic. Fracture resistance of each sample was measured by loading in universal testing machine. The results were analyzed with two-way ANOVA followed by multiple comparison Tukey HSD test.
The highest mean fracture resistance value (256.7N) was associated with Soft-Core/AH26 obturation and wave one (subgroup C), while the lowest value (239.8 N) was for Bioceramic sealer and Wave 1 (subgroup D); however, there was no statistical significant difference (P>0.05) among all tested subgroups.
All instrumentation techniques caused weakening of the root structure and made them susceptible to fracture without any significant difference and therefore alternative strategies should be considered to reinforce endodontically treated roots.

Following dental avulsion, the immediate recommended treatment is tooth replantation to avoid adverse effects. Therefore, the tooth must be stored in a physiological storage medium to preserve the viability of the periodontal ligament fibroblast (PDLF) cells during transportation to dental office. The aim of this study was to determine the effect of several storage media in preserving the viability of human PDLF cells at different times and temperatures. In this experimental study, the human PDL cells were obtained from the healthy extracted third molars and cultured in Dulbecco's Modified Eagle Medium (DMEM). The studied media were DMEM (10% FBS + 1% penicillin G Na (10000 IU) + 1% streptomycin (10 mg)), tap water, sterilized whole milk, zero fat milk and soy milk. After the cells had reached sufficient density in the plate, they were added to the experimental media and kept at 1, 2, 4 and 24 hours at 4° and 37oCentigrade. After incubation, the cell viability was determined by tetrazolium salt-based colorimetric (MTT) assay. The results were statistically analyzed  using Kruskal–Wallis and post hoc Tests. Whole milk and DMEM showed significantly higher protective effect than other media. The viability of PDL cells had significant difference at 4oC compared to 37oC at 4 and 24 h in DMEM group and at 24 h in whole milk group (p≤0.05). The results have suggested that the whole milk like DMEM have enough essential nutrients for PDLFs and have confirmed the hypothesis that the milk similar to HBSS or DMEM might be effective in preserving the PDLF cells.

Most of the materials used in endodontic procedures may lead to discoloration.This study compared the discolorations induced following treatment by MTA, CEM ,and Biodentine using a spectrophotometric analysis. In this experimental study Forty extracted mandibular anterior teeth were selected and sectioned from 2 mm below Cemento Enamel Junction(CEJ) using a disc. A retrograde method was used for drilling cavities 2 mm away from incisal edge. Then the cavities were washed using 5.25% NaOCL and normal saline and the samples were divided randomly into 4 groups. The cavities in groups 1, 2, and 3 were filled by MTA Angleus, Cem cement, and Biodentine, respectively as deep as CEJ level and they were sealed by 2mm of A3 composite color. All of cavities of group 4/control, were all filled by composite A3. Then the samples were stored in a glass incubator with 100% humidity and  under laboratory light .they were exposed to a spectrophotometric analysis within 6 periods from placement including base line, 1 week, 2 weeks, 1 month, 3 months, 6 months. The data were analyzed by SPSS 17 ,Tukey HSD and ANOVA statistical test. The results showed no statistically significant difference in discoloration rate during measurement periodsin each group. However, the discoloration rate varied in various materials. The minimum and maximum discolorations occurred in Biodentine and MTA, respectively and their difference was statistically significant.(p=0.033)Other groups showed no statistically significant difference. The biodentinehad minimum discolorations compared with other two materials; thus, it seems that it can be recommended for cosmetic areas.

The aim of this study was to assess the fracture strength of immature single-rooted teeth restored with fiber post and apical plug.
In this experimental study, fifty mandibular premolars were divided into five groups. The coronal and apical portions were cut to obtain15±1 mm root lengths and cleaning &shaping were performed. Peeso reamer #4 was passed the apex by 1 mm to simulate an immature tooth and the apical portion in group 1 to 5 was filled by lateral compaction of 5 mm of gutta-percha; 5 mm of mineral trioxide aggregate (MTA); 5mm of calcium enriched mixture (CEM) cement; 3 mm of MTA and 2 mm of gutta-percha by vertical condensation and 3 mm of CEM cement and 2 mm of gutta-percha, respectively. The remaining portion was restored with glass fiber post and self-etch cement and composite cores were built. Compressive load was applied at a crosshead speed of 1 mm/minute at 90 ° angle until fracture in a universal testing machine. Data were analyzed using ANOVA in SPSS16.
The mean±SD fracture strength was recorded 607.8±162.41 N, 700.48±183.24 N, 595.16±171.77 N, 886.36±382.92N, and 868.87±440.36 N in groups one to five, respectively. No significant difference was observed among the experimental groups (p=0.1).
In immature teeth requiring an apical plug, fiber post can be placed directly on the MTA and CEM apical plugs and there is no need for placing gutta-percha on the plug.

The current study aimed at determining the prevalence of complete isthmii in permanent teeth, using cone-beam computed tomography (CBCT) in a selected Iranian community.
Methods and Materials: In this cross sectional study, 100 CBCT images (from 58 female and 42 male patients) including 1654 teeth (809 maxillary and 845 mandibular teeth) were evaluated. Each tooth root was evaluated in axial plane (interval, 0.1 mm; thickness, 0.1 mm) from the orifice to the apex and from the apex to the orifice to detect the presence of complete isthmus. Scans of teeth with complete isthmii were reevaluated in axial, sagittal, and coronal planes with the thickness, 0.1 mm. Presence and absence of complete isthmii in each tooth was reported. The root canal was divided into 3 equal parts (cervical, middle and apical thirds), and isthmii were classified with respect to the start and end points. Findings were classified into 6 categories with respect to the start and end points of the isthmii: 1) the beginning and end in the cervical third; 2) the beginning in the cervical third and end in the middle third ; 3) the beginning in the cervical third and end in the apical third ; 4) the beginning and end in the middle third ; 5) the beginning in the middle third and end in the apical third and 5) the beginning and end in the apical third.
The prevalence of complete isthmus in permanent teeth was 8.6%, and the highest prevalence was reported in mesial roots of the mandibular first molars. In maxilla, the highest prevalence of complete isthmus was found in mesiobuccal roots of the maxillary first molars, whereas in canines and central incisors, no isthmii were detected. In the mandible, the lowest prevalence of isthmus was found in second premolars. In maxillary molars, isthmii starting and ending in the middle third of the root had the highest prevalence. On the other hand, isthmii in mandibular molars, from apical or middle third of the root beginning to the end of the apical third, had the highest prevalence.
As the prevalence of complete isthmii was the highest in molars, endodontists should pay particular attention to accomplish a successful surgical or nonsurgical root canal therapy.

Radiotherapy is one of the oral and pharyngeal cancer treatment methods that can cause damage to the tissues in the radiation area; the purpose of this study is to evaluate the effects of radiotherapy on dental pulp tissue in rats.
In this interventional, experimental double-blind study, 30 rats were studied in three groups (n = 10 each). The fi rst group received 12 gray (Gy), the second group received 18 Gy in one session, and the third group was not exposed to radiation (control group). The 5 μm sections of mandibular molar tooth were prepared and stained with hematoxylin and eosin. Samples were studied under optical microscope to evaluate and score infl ammation, necrosis, hyalinization, and vascular congestion. The data were coded and analyzed by statistical tests of χ² and Fisher’s exact tests. The signifi cant level of P = 0.05.
In Group 1, necrosis in two cases, infl ammation in one case, hyalinization in one case, and vascular congestion in four cases were observed. In Group 2, infl ammation in four cases, hyalinization in two cases, and vascular congestion in fi ve cases were observed. In Group 3, infl ammation was observed only in one case. In comparison between the groups, no signifi cant differences were observed in infl ammation (P > 0.05), necrosis (P > 0.05), and hyalinization (P > 0.05). However, the difference was signifi cant for vascular congestion (P Radiotherapy with doses of 12 and 18 Gy had no signifi cant effect on infl ammation, necrosis, and hyalinization in all groups; however, the difference was signifi cant for vascular congestion.

The aim of this study was to evaluate the root canal morphology of mandibular first and second molars using cone-beam computed tomography (CBCT) in northern Iranian population and also to indicate the thinnest area around root canals.
Methods and Materials: We evaluated CBCT images of 154 first molars and 147 second molars. By evaluating three axial, sagittal and coronal planes of each tooth we determined the number of root canals, prevalence of C-shaped Melton types, and prevalence of Vertucci configuration and inter orifice distance. Also the minimum wall thickness of root canals was determined by measuring buccal, lingual, distal and mesial wall thicknesses of each canal in levels with 2 mm intervals from apex to orifice.
Amongst 154 first mandibular molars, 149 (96.7%) had two roots, 3 (1.9%) had three roots and 2 (1.2%) had C-shaped root configuration. Of 147 second mandibular molars, 120 (81.6%) had two roots, 1 (0.6%) had three roots and 26 (17.6%) had C-shaped roots. There was no significant difference in the prevalence of Vertucci’s type between two genders. The most common configuration in mesial roots of first and second molars were type IV (57%-42.9%) and type II (31.5%-28%). Mesial and distal walls had the most frequency as the thinnest wall in all levels of root canals with mostly less than 1 mm thickness. In second molars the DB-DL inter orifice distance and in first molars the MB-ML distance were the minimum. MB-D in first molars had the maximum distance while ML-DL, MB-DB and ML-D had the same and maximum distance in second molars.
Vertucci’s type IV and type I were the most prevalent configurations in mesial and distal roots of first and second mandibular molars and the thickness of thinnest area around the canals should be considered during endodontic treatments.

Transportation is an important iatrogenic endodontic error which might cause failure. This study evaluated the canal transportation caused by Neoniti and ProTaper instruments, using cone-beam computed tomography (CBCT) cross sections.
Methods and Materials: This in vitro experimental study was performed on 40 mesiobuccal roots of maxillary first molars. The teeth were scanned with CBCT. They were randomly divided into 2 groups (n=20) that were prepared using either Neoniti or ProTaper files. An endodontist prepared the canal according to the manufacturer’s guidelines. Prepared canals were re-scanned. The pre-instrumentation and post-instrumentation CBCT volumes were sectioned at 1 to 9-mm distances from the apex. The extent of canal dentine removal in mesial and distal directions were measured in each cross-section. Canal transportation and instrument centering ability were estimated based on the extents of root wall removal and were compared in both groups.
The groups were rather similar in terms of transportation and centering ability (P>0.05). However, canal preparation on mesial and distal walls was statistically significantly less in the Neoniti group, at most cross-sections. Transportation of both groups was not significantly different (P>0.05). Centering ability of both instruments was not significantly different (P>0.05).
Neoniti and ProTaper instruments might have proper centering ability and minimum transportations. Both instruments might cause similar extents of transportation and centering abilities.

This case report describes the healing of a large periapical lesion without apical surgery. In this paper, s 35 year-old female with a large lesion from the apices of her teeth 22-27 is presented. During treatment procedure 2.5% sodium hypoclorite solution was used for irrigation and calcium–hydroxide was used as intracanal anti-microbial dressing. Periapical healing was observed in radiographic examinations at 6-month and 1 and 2 year-follow-up visits.

The aim of this study was to compare the diagnostic value of cone-beam computed tomography (CBCT) and periapical (PA) radiography in detecting internal root resorption. Methods and Materials: Eighty single rooted human teeth with visible pulps in PA radiography were split mesiodistally along the coronal plane. Internal resorption like lesions were created in three areas (cervical, middle and apical) in labial wall of the canals in different diameters. PA radiography and CBCT images were taken from each tooth. Two observers examined the radiographs and CBCT images to evaluate the presence of resorption cavities. The data were statistically analyzed and degree of agreement was calculated using Cohen’s kappa (k) values. The mean±SD of agreement coefficient of kappa between the two observers of the CBCT images was calculated to be 0.681±0.047. The coefficients for the direct, mesial and distal PA radiography were 0.405±0.059, 0.421±0.060 and 0.432±0.056, respectively (P=0.001). The differences in the diagnostic accuracy of resorption of different sizes were statistically significant (P<0.05); however, the PA radiography and CBCT, had no statistically significant differences in detection of internal resorption lesions in the cervical, middle and apical regions. Though, CBCT has a higher sensitivity, specificity, positive predictive value and negative predictive value in comparison with conventional radiography, this difference was not significant.

Fearless removal of tooth structure during canal preparation and shaping has negative effects on the prognosis of treatment. On the other hand, sufficient pre-enlargement facilitates exact measurement of the apical size. The present in vitro study aimed to compare the efficacy of Gates-Glidden drills, K3, ProTaper, FlexMaster and RaCe instruments in dentin removal during coronal flaring using cone-beam computed tomography (CBCT). Methods and Materials: A total of 40 mandibular molars were selected and the coronal areas of their mesiobuccal and mesiolingual root canals were randomly prepared with either mentioned instruments. Pre- and post-instrumentation CBCT images were taken and the thickness of canal walls was measured in 1.5- and 3-mm distances from the furcation area. Data were analyzed using the one-way ANOVA. Tukey’s post hoc tests were used for two-by-two comparisons. At 1.5-mm distance, there was no significant difference between different instruments. However, at 3-mm distances, Gates-Glidden drills removed significantly more dentin compared to FlexMaster files (mean=0.18 mm) (P<0.02); however, two-by-two comparisons did not reveal any significant differences between the other groups. All tested instruments can be effectively used in clinical settings for coronal pre-enlargement.

The aim of the present in vitro study was to evaluate the efficacy of D-RaCe, ProTaper retreatment kit and hand H-files in removal of obturating materials (OM) from the curved root canals using cone-beam computed tomography (CBCT). Sixty extracted molars were prepared and obturated. The samples were divided into three groups (n=20). In each group the OM was removed using hand H-files, D-RaCe and ProTaper retreatment kit. All the samples underwent CBCT imaging. The amount of OM was evaluated in CBCT sagittal cross-sections and scored. The maximum concentration of residual OM was recorded. The duration of the procedure (including the required time for reaching working length=T1 and total working time=TT) and procedural errors were also recorded. Data were analyzed using one-way ANOVA, Tukey’s post hoc test, Fisher’s exact test and Kruskal-Wallis test. The level f significance was set at 0.05. No significant differences were observed in the residual OM among the three groups. T1 and TT were not significantly different in all the groups. There were no significant differences in concentration of OM between the groups (P<0.05). In relation to procedural errors, 4 and 5 cases of file fracture were recorded in the ProTaper and D-RaCe groups, respectively, with no significant differences. Rotary and hand files had similar efficacy in removing root canal filling materials but instrument fracture occurred more frequently in rotary files.

Apical transportation changes the physical shape and physiologic environment of the root canal terminus. The aim of the present experimental study was to determine the extent of apical transportation after instrumentation with hand K-Flexofile and K3 rotary instruments by means of cone-beam computed tomography (CBCT). Methods and Materials: Forty mesiobuccal root canals of maxillary first molars, with 19-22 mm length and 20-40° canal curvature, were selected and assigned into two preparation groups. The first group was prepared with K-Flexofile with passive step-back technique and the second group was prepared with K3 rotary instruments. Pre and post instrumentation CBCT images were taken under similar conditions. The amount of root canal transportation was evaluated by Mann-Whitney U test and the chi-square test was used for the qualitative evaluation. The amounts of apical canal transportation with the K3 and K-Flexofile instruments were 0.105±0.088 and 0.150±0.127 mm, respectively with no statistically significant differences. In the manual technique, 25% of the canals had no apical transportation; while 30% of the canals in the K3 group were transportation free. Both systems were able to preserve the initial curvature of the canals and both had sufficient accuracy. Preparation with K3 rotary instruments resulted in apical transportation similar to that of K-Flexofile.

Diabetes mellitus is a chronic disease which affects the healing ability of the pulp and periodontium. The aim of the present study was to assess the histopathologic response of dental pulp to pulp capping using MTA or CEM cement in diabetic rats. Thirty two Wistar male rats aged between 8 and 10 weeks (weight: 200-250g) were divided into two groups of diabetic (n=16) and healthy (n=16) animals and then subdivided into MTA and CEM subgroups. In each group, 10 MTA treated, 10 CEM treated and 12 intact (without any intervention) teeth were analyzed. Intact teeth were considered as a baseline inflammation control. Then, class I cavity was made in the maxillary first molars teeth with pinpoint pulpal exposure. Either MTA or CEM cement was then placed over exposed pulp as pulp capping agent and the cavities were restored using resin- modified glass ionomer cement. Both teeth of rats in subgroups remained intact without any intervention. After four weeks, the rats were sacrificed and the teeth were subjected to histological evaluation in terms of inflammation intensity, dentin bridge formation and dentin bridge continuity. The CEM cement treated diabetic rats exhibited a significant higher inflammatory response when compared to healthy control group (P=0.004) whereas, MTA treated diabetic rats did not exhibit a significant higher inflammatory response in comparison to healthy controls. There was no significant difference between MTA and CEM cement in the induction of dentin bridge formation in diabetic and healthy controls. This preliminary study suggests that MTA is a superior dental material than CEM cement for pulp therapy in subjects with diabetes.

Due to the importance of apical transportation during root canal preparation, the aim of the current study was to use cone-beam computed tomography (CBCT) to assess the extent of apical transportation caused by ProTaper and Mtwo files. Methods and Materials: Forty extracted maxillary first molars with 19-22 mm length and 20-40 degrees of curvature were selected. The mesiobuccal canals were prepared using either Mtwo or ProTaper rotary files (n=20). CBCT images were obtained before and after canal preparation to compare the apical transportation in different cross-sections of mesial and distal surfaces. The apical transportation values were analyzed using the SPSS software. The results were compared with student’s t-test and Mann-Whitney U test. There was no significant difference in the extent of apical transportation between Mtwo and ProTaper systems in different canal cross-sections. The apical transportation value was less than 0.1 mm in most of the specimens, which was clinically acceptable. Considering the insignificant difference between the two systems, it can be concluded that both system have low rates of apical transportation and can be assuredly used in clinical settings.

This research administered with the aim of investigates the moderating role of cultural values in relationship between justice and injustice with athletes’’ destructive behavior. Statistical population was the one thousand of athletes from first and second faction of country competitions in different field. From, 264 athletes selected with the use of simple random sampling for answering to distributive injustice questionnaire with 5 items, interactional justice with 4 items, procedural justice with 4 items, materialism with 3 items, power distance with 5 items and destructive behaviors with 9 items (with two subscales including try to exit or change the club with 3 items, and neglect/aggressive voice with 6 items). Data analyzed with using correlation analysis and moderated hierarchical regression analysis. Results showed that materialism moderate the relationships between distributive injustice, interactional justice and procedural justice with try to exit or change the club, and relationship between distributive injustice with neglect/aggressive voice. Power distance also only moderates the relationship between interactional justice with try to exit or change the club. But power distance has not moderating role in relations between injustice and justice dimensions with neglect/aggressive voice.

In direct pup capping, the exposed pulp is directly capped with a capping material to provoke a dentinal bridge formation to seal the exposed area.The aim of this study was to evaluate the pulpal response to MTA and capsaicin in cats. The sample for this experimental study consisted of 24 canines of cats, weighed approximately 3-4kg. After sedation, the teeth were cut and exposed at 3mm above cementoenamel junction, then divided into two groups: 1) direct pulp capping with MTA 2) direct pulp capping with Capsaicin. The cavities were filled with glass ionomer cement (Fuji IX). The cats were sacrificed in the first, second, and fourth weeks 4 canine teeth were extracted for the purpose of histologic analysis. 6Serial sections were cut parallel to the longitudinal axis of the canines. The sections were stained with hematoxylin & eosin, and were observed and analyzed using a light microscope. In both groups treated with MTA and capsaicin, the inflammation decreased during weeks1, 2, and 4. Less inflammation was seen in MTA group but there was no statistical difference between the two groups (p=0.22). In the group treated with capsaicin, necrosis was observed in every 12 samples, but in the other group treated with MTA, only 1 pulp necrosis was seen in the first week (p=0.000). There was no significant difference in dentinal barrier formation, inflammatory response, and soft tissue changes between the two groups. The results of this study showed that capsaicin can decrease the severity of inflammation, but it is ineffective in dentinal barrier formation.